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VATS Resection Using a Single Vertical Incision

Tuesday, February 24, 2015

A 67-year-old man was admitted for treatment of a 5x4 cm anterior mediastinal mass, which was found incidentally on a chest radiograph and was confirmed by a chest CT. The patient had no prior complaints. There was no evidence of metastatic disease on PET/CT. The mass was resected via VATS, using a single vertical incision. The instruments were inserted in the midaxillary line and the third intercostal space. A 30-degree scope was inserted in the fourth interspace, through the same skin incision. The vertical incision provided a large working area for the instruments. After the mass was resected, the drain was inserted through the same incision. The postoperative period was uneventful. Histopathologic examination revealed a T2N0M0 thymic squamous cell carcinoma with clear margins. Adjuvant therapy was not recommended.

Comments

Yes, you are right theorically. I contribute to you about this issue. But, we didnt have preoperatively diagnosis,although we think probable early stage thymic lesion. The thymus gland tumours can spread into nearby structures. However, the full extent of the tumour can often only be accurately assessed during surgery. We observed that tumor is completely encapsulated and macroscopically not invaded surrounding fatty tissue or any adjacent to mediastinal structure.But , again, may be microscopically tumor spread to adjacent structure and should be done complet thymectomy beside tumor resection.In this patient, pathologic examination was revealed stage I thymic squamous carcinoma, encapsulated and there is no invasion in extracapsular fatty tissue. we will observe surveillance for recurrence with CT every 6 months for 2 years,then annually for 5 years.Thanks to your comment.

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